Case management service quality and patient-centered care

Providing care that is patient-centered is an important objective in the modern healthcare industry. Despite this objective, hospital inpatient case managers and the services they provide are evaluated routinely without including patients' perspectives. Therefore, the purpose of this study is to fill this research gap by using patient expectations and perceptions to assess the overall quality of and patient satisfaction with hospital case management services.

This paper investigates five dimensions of case management services - reliability, responsiveness, assurance, empathy and tangibles - and how they affect overall quality and patient satisfaction. Study surveys are based on the SERVQUAL instrument. Survey data from a cross-sectional sample of 67 inpatients are analyzed using principal component analysis, confirmatory factor analysis, GAP analysis and a predictive model.

The preliminary part of the study identifies "tangibles" and "nontangibles" - reliability, responsiveness, assurance and empathy - as the main components. Among these two components, only nontangibles have a positive and significant effect on both quality and patient satisfaction according to patient perspectives. GAP analysis indicates that gaps between patient expectations and perceptions of reliability and assurance are significant. Finally, the proposed predictive model reveals that gaps in assurance have a significant impact on both overall quality and satisfaction, while gaps in empathy have a significant impact on satisfaction, but not overall quality.

Studies on service quality at the case manager level are limited. This study is the first in this domain to evaluate quality and satisfaction from the patient perspective.